Yes. The RCPA Manual notes iron deficiency can be present before anaemia develops; ferritin is the most sensitive measure of iron stores, interpreted with inflammation in mind.

Repeat the platelet count using a citrate, oxalate or heparin specimen; the count may normalise or be substantially higher. Review the film and exclude a partly clotted sample.

Iron deficiency can lower HbA2 and make beta-thalassaemia trait appear falsely normal. In pregnancy, testing should not be delayed because identifying at-risk carrier couples matters.

If clinical findings are concerning, or lymphocytosis persists for more than three months with uncertain cause, peripheral blood immunophenotyping may help. Film morphology and clinical context guide evaluation.

No. RCPA notes that normal initial results do not absolutely exclude disorders such as von Willebrand disease, platelet function disorders or factor XIII deficiency. Let the history guide further evaluation.

Consider chronic blood loss, particularly uterine or gastrointestinal loss; occult bleeding and gastrointestinal malignancy are among the considerations. Assess the likely cause, not just the low iron.

Haemorrhagic disease of the newborn is listed among causes associated with vitamin K deficiency. The vitamin is required for normal synthesis/activity of multiple coagulation factors.

Review recent viral illness and exposure to drugs or toxins. Check the full count, differential and film; broader cytopenias may suggest a different process than isolated neutropenia.

Ask about spontaneous or excessive bleeding after trauma, surgery, dental work or childbirth; prior treatment, medicines and family history also guide investigation.

Examples in the RCPA Manual include sepsis, massive trauma and obstetric syndromes; acute promyelocytic leukaemia is another. Interpret coagulation results in the clinical context.

Factor VIII assay assesses haemophilia A; factor IX assay assesses haemophilia B. RCPA recommends initial characterisation and ongoing management in consultation with a recognised Haemophilia Centre.

Vitamin B12 and folate deficiency. The RCPA anaemia framework also includes alcohol, hepatic failure, myelodysplasia, medicines and hypothyroidism among macrocytic causes.

Consider intrinsic-factor deficiency/pernicious anaemia, gastrectomy, ileal disease or resection, and blind-loop-related competition. History helps identify the mechanism; assess FBC, film, B12 and folate.

It helps frame the marrow response alongside the full blood count and film. Further testing should follow clinical features and red-cell indices; anaemia can have more than one cause.

Exclude secondary dysplastic changes, including nutritional deficiency, medication effects and acute illness or inflammation. MDS involves clonal haematopoiesis, cytopenia(s), dysplasia and ineffective blood-cell production.

Inflammation/chronic disease, early iron deficiency, marrow failure or infiltration, dilution, haemolysis and acute blood loss before marrow response. Use history, reticulocytes and film to direct tests.

Transferrin saturation. RCPA also recommends ferritin and, in appropriate patients being evaluated for overload, HFE genotyping.